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Colonoscopic findings in first-degree relatives of patients with colorectal cancer: a population-based screening program.

Abstract：

BACKGROUND:A screening colonoscopy is recommended in first-degree relatives (FDRs) of colorectal cancer patients; few prospective, controlled studies have evaluated colorectal findings in a population-based screening program. OBJECTIVE:To evaluate the prevalence of colorectal neoplasia (adenomas and adenocarcinomas) in this increased-risk population, to compare it with that of average-risk individuals, and to identify features that might allow risk stratification for neoplasia among FDRs. DESIGN:Cross-sectional study. SETTING:Population-based screening program in Trentino, Italy. PATIENTS:FDRs of colorectal cancer patients between 45 and 75 years of age with no history of hereditary colorectal cancer syndromes or inflammatory bowel disease. CONTROLS:Average-risk individuals undergoing screening colonoscopy. INTERVENTION:Screening colonoscopy. RESULTS:Neoplasia was found in 33.4% of 1252 FDRs and in 30.3% of 765 controls; advanced neoplasia was found in 11.3% of FDRs and in 6.3% of controls. Odds ratios (ORs) from the multivariate logistic regression analysis adjusted for age, sex, cecal intubation rates, and colon cleansing showed an increased risk of advanced neoplasia (OR 2.41; 95% CI, 1.69-3.43; P < .0001) in FDRs. Age older than 56 years (OR 1.83; 95% CI, 1.15-2.99; P = .013) and male sex (OR 2.17; 95% CI, 1.39-3.10; P < .001) are independent predictors of advanced neoplasia. LIMITATIONS:Italian subjects living in the same geographic area; of 4301 FDRs, 2521 were excluded. CONCLUSIONS:The increased risk of advanced neoplasia supports the current recommendation for colonoscopic screening in this group; age and sex may assist in risk stratification of these individuals.

journal_name

Gastrointest Endosc

journal_title

Gastrointestinal endoscopy

authors

Armelao F,Paternolli C,Franceschini G,Franch R,Orlandi PG,Miori G,Avancini I,Togni M,Rossi M,Meggio A,Tasini E,Manfrini R,Giacomin D,Fasoli R,Faitini K,Mastromauro M,Costa S,Ridolfi F,Rosi P,de Pretis G

doi

10.1016/j.gie.2010.12.025

subject

Has Abstract

pub_date

2011-03-01 00:00:00

pages

527-534.e2

issue

eissn

0016-5107

issn

1097-6779

pii

S0016-5107(10)02500-9

journal_volume

pub_type

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Colonoscopic findings in first-degree relatives of patients with colorectal cancer: a population-based screening program.